How I Did It: Keto Without A Gallbladder

Hello. My name is Chelsea, and I do not have a gallbladder. Yet, I've been able to successfully follow a ketogenic diet long-term. I had to tweak the diet, pay close attention to my body, and learn (mostly by trial and error) the warning signs for when I went too far. There are multiple resources out there that touch on this subject, but none of them provided a comprehensive how-to guide. So, I decided to create one! I've included all the things that I wish I knew when I was starting out with keto. Most of these tips are things that I still do today. I hope this helps you on your own path to a healthy lifestyle.

Before we dive in, it is important to mention that I am not a doctor. I achieved success by following a customized keto diet, and I am simply sharing what worked for me. However, this may not work for everyone. It is important that I point out the following:

I make no guarantees or assurances that others will achieve the same results and I did. I am not a medical or nutritional professional. All content on Modern Yum is for informational purposes only. The information provided on this site should not be substituted for medical advice, diagnosis or treatment. I cannot guarantee that the information provided reflects the most up-to-date medical research. Please consult with your doctor before starting any new diet or exercise program.

Disclaimer: Please note that some of the links below are affiliate links and I will earn a commission if you purchase through those links. I only link to products and retailers that I have used personally and recommend.

You can view my full terms and conditions here. Now that that's out of the way, let's dive in to how I successfully maintain ketosis without having a gallbladder.

How I went from low-fat to keto

I had a cholecystectomy (surgery to remove the gallbladder) when I was 24 years old. Yes, 24. I had eaten a low-fat diet for years, and the bile in my gallbladder had turned from a liquid into, as my doctor called it, "sludge." After multiple trips to the hospital, I became one out of half a million people that have their gallbladders removed every year.

After the surgery, my doctor told me to avoid eating fats, so I took my already low-fat diet to the extreme. And I mean EXTREME. And although I was constantly eating steamed broccoli and chicken breast, I was gaining weight. Slowly but surely, year after year, the trend was always up. I had completely accepted the fact that I could not eat any fat for the rest of my life. I considered it to be a blessing-in-disguise, forcing me to eat "healthy." 10 years later, I realized that it just wasn't working for me, and that something needed to change.

Doing keto without a gallbladder has its challenges. I have had to make changes and adjustments, ignore the "keto police" internet comments about what I can and cannot do, and adjust the diet to work for me. But it does work, and it is possible.

Keto Without a Gallbladder: Where To Start

If you're just getting started, it can be hard to know where to start and what to do. There's a lot of information out there, but a lot of it is unhelpful and overly complicated. Here is a list of basic things you should start doing right away.

Give Yourself Time

It will take your liver some time to learn to produce bile on-demand. I recommend you wait at least 4 months after surgery before trying a high-fat diet. Give your liver time to adjust.

• Right after surgery you should eat a low-fat diet. Your body is recovering from surgery, so eat foods that are easy to digest. During this period, chicken bone-broth soup is your best friend.
• After about a month, start adding small amounts (about one teaspoon) of healthy fats here and there.
• After another month or so, try drizzling a tablespoon of olive oil on a salad or butter on your veggies.
• Once it's been several months since your surgery, you should be familiar with what your body can handle. Only YOU know when the time is right to try a high-fat diet.

Note: my suggestions above do NOT overrule anything your doctor tells you. These are general guidelines, but each situation is different so always listen to your doctor.

Smaller Meals, More Often

Eat multiple small meals throughout the day. Your goal should be to eat like a hobbit: breakfast, second breakfast, elevenses, lunch, afternoon tea, dinner and supper. Roughly twice the number of meals as "normal" people. Snacking throughout the day is something to be proud of. Tapas are your best friend. A 3-course dinner party that lasts several hours? Perfect. Eating a series of appetizer-sized plates prevents you from having one large meal. Just make sure your meals/snacks are healthy. Having 10 snacks a day of highly-processed foods will not do you any favors.

"OMG I'm STARVING" is your worst nightmare. Don't let yourself get to that point. If it does happen, eat a snack or appetizer before digging into a meal.

Do NOT force yourself to finish your plate. Like many, I grew up on the notion that I had to finish my plate. So, I had to re-train my brain not to think this way. In order to re-train myself, I made a rule that no matter what, I had to leave at least one bite on the plate. Eventually I got used to it and leaving that last bite didn't cause a panic of "must finish!" in the back of my mind. Nowadays, I often make myself a plate, eat most of it, but leave a few bites on the plate. I put the rest of it in the fridge and then finish it off an hour or two later. My husband often makes fun of me for leaving two bites of something on a plate, but it's important to stop yourself, even if you only have a couple bites left. You don't have to waste it, just consider it a snack for later.

Keep a Food Journal

The goal is to find a pattern between what you are eating and what symptoms you get. For example, I noticed that I sometimes get a headache if I eat too much peanut butter, and that 24-48 hours after eating pork I'll get a terrible upset stomach.

Do I have to Avoid Fat?

As my physician told me "about half of people without a gallbladder can digest fat just fine, and the other half have problems." But even if you are considered the "other half with problems" and find that keto is too much for you, you can, and should, still be consuming some healthy fats. You just have to be careful, eat small portions, and pay attention to your body so that you don't overdo it. Healthy fats are essential to your bodily function, so regardless of which category you fall under, you should find a way to be consuming at least a small amount of healthy fats each day.

You can still eat and digest fat

Bile is what helps you digest fat. The liver produces the bile, and the gallbladder stores it. Think of your liver as the factory and the gallbladder as the storage unit. Your liver can still produce bile, it just doesn't have a storage unit to keep it in. So the liver needs to learn to make bile on-demand, and it sends it straight to the small intestine. This means that if you eat a massive meal of fatty foods, your liver won't be able to produce enough bile in the moment and you'll end up with a stomachache (and an over-worked liver). On the other hand, if you eat a small amount of fat your liver will gladly produce some bile to help digest it, and you'll be A-OK. And if you eat another small meal a couple hours later, no problem. You can still digest fat, you just can't eat a ton of it all at the same time.

Is keto a good diet for me?

Maybe. Maybe not. Honestly, you’ll just have to try it and see how your body does on the diet. You might feel great. You might feel horrible. Listen to your body.

Doing keto without a gallbladder is certainly possible. I know because I'm doing it. Due to other health benefits, such as lowering your chance of getting diabetes, I recommend it. However, if keto is not for you, that's ok. But you still need to learn how to incorporate healthy fats into your diet. Healthy fats, such as avocado oil and olive oil, are essential to brain function, hormone regulation, nutrition absorption, and many other essential bodily functions. You cannot simply exclude fats from your diet.

There is very little research on patients who do not have a gallbladder and follow a high-fat diet. I know that it’s possible in the short-term, but what about the long-term effects? At this point in time, there is not enough research to know. For me personally, I know that a low-carb diet helps me lose weight and manage symptoms from other issues I have. But, knowing that I do not have a gallbladder, I try to do a semi-high-fat diet instead of an extremely-high-fat diet. Eating high fat does take a toll on your body (especially your liver and intestines) in the long run, and patients without a gallbladder are already more prone to developing fatty liver disease and metabolic syndrome. I don’t want to make it any worse if I can help it. Therefore, even though I follow a low-carb-high-fat diet, I don’t do “dirty keto,” I try to use olive oil instead of bacon, and I limit my dairy intake. These small things can make a difference.

In my Meal Plan for Keto Without a Gallbladder, I provide a keto meal plan and then also include an alternative meal plan for anyone whose digestive system can’t handle doing keto 100% (or for anyone who wants to do low-carb but not so extreme as keto). Just because you’re only semi-keto doesn’t mean you can’t still reap the benefits, lose weight and get healthier. I know that many of you won’t be able to do full keto, and I don’t think it’s healthy to force your body to do it, which is why the alternative meal plan is already included as a back-up option. The guide also includes grocery lists, recipe suggestions, and a tons of information and tips to get you started on the right track.

Step-by-Step Guide and Meal Plan

This is a custom meal plan for anyone who wants to successfully do keto without a gallbladder. Included in this guide are TWO different meal plans to choose from: strict keto and a less-strenuous alternative. Plus, get grocery lists, recipe suggestions, and a tons of information and tips to get you started on the right track.

The heavier you are, the harder it will be

Sorry to be the bearer of bad news, but it’s true. This is a major point that most other resources don't mention, yet it’s a key factor for setting you up for success instead of failure. As you can see from the charts below, the heavier you are, the more calories you are allowed to eat. That makes sense: someone who is 150 pounds will eat less total food, and have a diet with less total calories, than someone who is 300 pounds. Here’s where it gets tricky for keto: if you are eating more calories in general, then you will also be eating more fat, and if you’re eating more fat, your liver must work harder to digest that fat.

In the example below, a person consuming 2,375 calories per day on the keto diet will need to digest about 185g of fat, whereas someone consuming 1,622 calories per day will only have to digest 127g of fat. That's a difference of 58g of fat per day, which may be the difference between tummy problems and no tummy problems. All the dandelion tea in the world isn’t going to compensate for having to digest an additional 58g of fat per day.

Does that mean that heavier people cannot do keto? Not necessarily. It just means that the heavier you are, the more important it is that you transition slowly, listen to your body and learn your limits. Each body is different and has different limits. You may want to consider doing a “Low Carb Moderate Fat” diet first as a transition diet. If you are using the Carb Manager app, there is a setting for this. Try that for a few weeks. If you do ok, then try transitioning to full keto. You may also consider taking Ox bile supplements until you can get your weight down.

Low Carb High Fat (LCHF) Diet / Keto Diet

Macros	Weight: 150 lbs	Weight: 300 lbs
	Calories: 1,622	Calories: 2,375
Net Carbs: 5%	Net Carbs: 20g	Net Carbs: 30g
Protein: 25%	Protein: 100g	Protein: 148g
Fat: 70%	Fat: 127g	Fat: 185g

Low Carb Moderate Fat (LCMF) Diet

Macros	Weight: 150 lbs	Weight: 300 lbs
	Calories: 1,622	Calories: 2,375
Net Carbs: 20%	Net Carbs: 81g	Net Carbs: 119g
Protein: 40%	Protein: 162g	Protein: 238g
Fat: 40%	Fat: 72g	Fat: 106g

As you can see from this chart, a Low Carb Moderate Fat Diet is very different from the standard keto diet. It will be much easier for you to consume 106g of fat than to consume 185g of fat. You may want to consider doing LCMF first, as a steppingstone that you can use during your transition into keto.

Ox Bile supplements may also assist with digesting fat until you can get your weight down. Then, you can try to slowly transition off of the supplements if your body allows.

It's not always a gallbladder problem

After my gallbladder was removed, I blamed every single tummy-ache on my non-existent gallbladder. I would think to myself "I must have eaten too much fat." That was clearly not the case, since I was eating an extremely low-fat diet, but hindsight is 20-20. There are other reasons why your belly might be angry with you, so don't let your gallbladder problems take the blame for everything.

There was a span of about a year and a half where I had particularly bad stomachaches and bloating. Like, really bad. I went to the G.I. doctor multiple times, was prescribed various medicines, but nothing helped. Then, one day the doctor suggested I try probiotics. Lo and behold! It was like a switch turned off and after only a few days my stomachache completely disappeared. After over a year of suffering, all I needed was some probiotics. So, learn from my mistake and do not assume that every upset stomach is caused by your non-existent gallbladder. In this case, it was a round of antibiotics I had taken a year prior that was the culprit.

How's your poo?

Let's talk about poop! If you're doing keto without a gallbladder, then it's important to pay attention to your poo. Bile is what makes your poop brown, so the color of your poo is a good indicator of how your tummy is doing. Bile starts out as a yellowish-greenish color and then turns brown during digestion. If your poop is an unusual color, it's important to know what's causing it. Besides a stomachache, diarrhea and bloating, your poop color is a good way to tell if you're eating too much fat and/or not producing enough bile. Here's a poop-color guideline:

• Pale / white / chalky - this is a sign of not enough bile. Though some medications may also cause this (did you take any anti-diarrhea medicine lately?), I typically view this as a sign that I ate too much fat for my liver to handle. If it still persists after reducing your fat intake, see a doctor.
• Yellow / greasy / super stinky - yellow stool could be from something you ate, but it could also be a sign of too much fat. Especially if it's greasy / fatty / super smelly (even more than usual), you are either not producing enough bile, or you may have an absorption problem (common with celiac disease). If it persists, you should see a doctor.
• Orange - probably from eating carrots or other foods with beta-carotene, but it could also indicate that you aren't getting enough bile. If it persists, you should see a doctor.
• Green - probably from those green veggies you ate. If it accompanies diarrhea, it's probably because you have plenty of bile (yay!) but it went through your system so fast that it didn't have time to turn brown. If it persists, you should see a doctor.
• Red or black - Pepto-Bismol, iron and other supplements may turn your stool black. Red food coloring, cranberries, beets, tomatoes or other very-red foods may turn your stool red. However, red or black stool might also indicate bleeding in the digestive tract. If it persists, you should see a doctor.

As a general rule: unusual poop color in the short-term is ok and probably due to something you ate, but long-term might indicate an issue and you should see a doctor.

Starting Keto Without a Gallbladder

I mentioned before that it is possible to do keto without a gallbladder, but not without some alterations. Well, here they are! You may find that some of these tips work better than others for you, every body is different. I have found that some of these make little difference, while others make a huge difference. Over time you'll learn what works for you and what doesn't. In the beginning, I highly recommend that you keep a food journal.

Ignore the "Keto Police"

There are lots of blogs, forums and social media groups with information about keto. That's great! But very few of them discuss doing keto without a gallbladder. Most authors/commentators have their gallbladders and don't have the same issues/limitations that we do. So do your research, join a group, learn about the diet... but take everything with a grain of salt. If someone tells you that you must do fasting for keto to work, they are wrong. If someone tells you that it's 100% guaranteed that you can/can't do keto without a gallbladder, they're wrong. If you're told that everything you eat must be 100% gluten free and low-carb wraps/breads are not OK, they are wrong. It's "dirty keto" but it's still keto.

Personally, I try to stick to "clean keto" and avoid "dirty keto." I avoid gluten, chemical sweeteners, etc. when I can. But even as I write this, my tummy is not OK today and I am munching on a low-carb wrap (made of wheat) as I type because it settles my stomach and makes me feel better without kicking me out of ketosis. It's not the end of the world. And even if I did get kicked out of ketosis (like I did a few weeks ago when I made chicken noodle soup with (gasp!) real noodles), so what? I was back in ketosis by the very next day. As long as it doesn't happen often, it's ok. Give yourself a break. Besides, a "carb-up" is a real thing that can actually be beneficial on the keto diet. So I don't worry about it. (I should clarify: In the beginning, for the first few weeks when your body is transitioning into ketosis, you will have to be strict. Otherwise, you will never get into ketosis. But afterwards, once you are fat-adapted, you can give yourself some leniency to do what you need to make yourself feel good and make this diet work for you long-term.)

So, just to be clear: always remember that information about keto is usually NOT customized for doing keto without a gallbladder. You will have to make some adjustments, and that's ok. You're not cheating, you're customizing.

Start Slow

Most people start keto cold-turkey, but I gave myself a 2-week ramp up period. During those two weeks I slowly started decreasing my carb intake and slowly started increasing my fat intake. I had no idea how much fat my body could handle. Absolutely no idea. Even adding just a small drizzle of oil to my plate seemed like it would set of some hidden alarm bell somewhere. But nothing happened, and I was shocked to learn that I was actually digesting the fat fairly well. During this time I did not take supplements like ox-bile, because I wanted to see what my body could handle on its own. I also did NOT count calories or aim for certain nutritional goals. My total calories were probably quite high during those two weeks. I have no idea. I didn't count. My only goal was to slowly increase my fat intake, day by day, to see if I would do ok. Keep it simple, and set one goal at a time.

On that day, I started counting my net carbs and overall macros to be in line with keto guidelines. It took me another week or two to get into a good rhythm and consistently hit my macros correctly. There were some days when I just couldn't eat as much fat as I was supposed to. I learned by trial and error which fats I could digest easier and which foods gave me more trouble. I learned that coconut-oil fat bombs and MCT in my tea helped me stay on track. For me, it took two weeks; for you it might take longer. Just make sure you go slow and listen to your body. The diet will never work if you are so strict that you make yourself sick.

Soluble Fiber

When you eat soluble fiber along with fats, the fiber turns into a gel and slows down the digestive process. If you're doing keto without a gallbladder like me, this is important because it gives your liver more time to produce the bile. Bonus: soluble fiber also helps prevent constipation, lower your cholesterol, maintain lower blood glucose levels and promote healthy gut bacteria. You should try to include some type of soluble fiber with every meal.

With fruits and vegetables, usually (but not always) the outside peel is mostly insoluble fiber and the softer inside is mostly soluble fiber. So, plants where you only eat the inside, like bananas, pumpkin, edamame, are sunflower seeds, are typically great choices for soluble fiber. For other plants where you eat the skin, like apples and eggplants, keep in mind that the skin will be mostly insoluble fiber and the inside is where the soluble fiber lies. Insoluble fiber is important too, so don’t feel like you need to get rid of it or stop eating it. Insoluble fiber provides bulk and is also important to digestion. However, it can cause flare-ups for people with IBS when eaten in excess, so it’s something to monitor and pay attention to.

Here is a list of keto-friendly foods that are high in soluble fiber:

• Brussels sprouts
• Asparagus
• Avocado
• Broccoli
• Turnips
• Carrots
• Flax seeds
• Chia seeds
• Sunflower seeds
• Nuts
• Lupini beans
• Psyllium - this is a unique ingredient that you may not have used before. It's fairly common in low-carb/keto baking and can be used to thicken soups and stews in lieu of flour. I recommend getting some psyllium powder and adding a little to any soup, stew or sauce that you make. It's also a natural laxative, so don't go overboard with it either.
• Raspberries
• Spinach
• Soybeans (including edamame)
• Pumpkin and squash
• Green peas
• Inulin powder (add to smoothies and drinks)
• Acacia Senegal powder (add to smoothies and drinks)

Help a liver out!

Some foods naturally stimulate bile production in the liver. Awesome! Most of these are considered "bitters" (yes, the same thing that's in your cocktail). To get the full effect, make sure you taste them and chew slowly, as that will send signals to the liver and give it a head start. You get bonus points for eating these as an appetizer, ahead of the main meal. I like to munch on some cucumber or sip tumeric/ginger tea while I'm getting the main meal together. Here is a list of foods that naturally stimulate bile production:

• Artichokes
• Arugula
• Dandelion root (usually drank as a tea)
• Mint, which can be eaten with meals, drank as a tea or infused in water
• Parsley
• Radish
• Endive
• Radicchio lettuce
• Chicory
• Cilantro
• Celery
• Cucumber
• Tumeric, which can be sprinkled into eggs, smoothies, tea, oatmeal, etc.
• Ginger, which can be eaten with meals, drank as a tea or infused in water (ginger also helps ease an upset stomach; lemon ginger tea is my go-to when my belly hurts)
• St. Mary's thistle / milk thistle (usually drank as a tea)
• Green tea
• Sauerkraut
• Lemon/Lime
• Dark chocolate
• Kale
• Coffee
• Dill
• Sesame seeds
• Mustard

You can take a "liver tonic/cleanse" supplement in pill form to help as well. They should contain some of the above ingredients (usually dandelion, milk thistle and globe artichoke). This is good for an every-once-in-a-while help to your liver, but they are generally not meant for long-term use.

Note: if you have stomach ulcers, you should talk to your doctor about your choice of bitters, as some will irritate ulcers more than others.

Avoid foods that are hard to digest

This may seem obvious, but it's worth saying: avoid foods that are hard to digest. This includes grains and dairy. Gallbladder issues are sometimes caused by food intolerances, and just because you got rid of your gallbladder doesn't mean that the food intolerance disappeared. It will still wreak havoc on your system. Food intolerances can be tricky, because the effects aren't as obvious or immediate as a food allergy. Luckily, most keto recipes avoid grains. However, many keto recipes contain a ton of dairy. I'll be the first to admit that I eat too much dairy. But it's not a good long-term solution if you want to avoid further digestive issues down the road.

Apple Cider Vinegar (ACV)

Add apple cider vinegar (ACV) to your meals when possible. The malic acid in ACV thins bile, which makes it easier for the bile to move around the intestinal dance floor and boogie with the fats. ACV can also help with nutrient absorption. Overall, it's a great addition to you diet. Any time a recipe calls for vinegar, use ACV. You could also use it on salads along with olive oil. If you're up for it, mix together the following ingredients and keep it in the fridge. Then, take a swig before/during each meal (through a straw is better, as the acid can weaken your tooth enamel if you drink it on a regular basis). It's best to buy ACV raw, unfiltered, and with “mother” included.

• 2 tablespoon ACV
• 12oz water or iced tea
• 3-4 drops of stevia or monk fruit
• Shake of salt (Pink Himalayan is better, especially to avoid keto flu)
• Optional: Lemon juice, cinnamon and/or cayenne

MCT Oil

MCT oil does not require bile to digest! I repeat, MCT oil does NOT require bile to digest. Due to its unique structure, MCT oil gets absorbed right away and your body does not need to produce bile to digest it. For those of us doing keto without a gallbladder, this is an amazing way to get enough fats in your diet. But MCT can be tricky. Here are some pointers:

• MCT = Medium Chain Triglycerides (most other fats are "long chain," which are more complex and harder to break down)
• For some people, regardless of if they have a gallbladder or not, MCT oil gives them an upset stomach. So, be careful not to overdo it and start with a small amount and increase over time. The first time you use MCT oil, start with a teaspoon and see how you do. You can increase from there.
• No more than 50% of your fats should come from MCT. I know it's tempting, but don't overdo it. Personally, I stick to about 25%. I try to use no more than one tablespoon per meal, once per day (maximum twice per day). Eating too much of it can cause a fatty liver.
• MCT oil gives you quick energy. It is absorbed immediately, without the need for bile to break it down. This quick energy can be a good thing, especially as a pre-workout meal/snack. But on the other hand, it does not provide the long-lasting energy and fullness of most fats. I personally don't feel as full when eating MCTs, which can lead to overeating.
• MCT is natually found in several types of foods. You do not need to buy pure MCT oil if you cook with coconut oil on a regular basis.
  • Coconut oil: 55% MCT
  • Palm kernel oil: 54% MCT
  • Whole milk: 9% MCT
  • Butter: 8% MCT
  • Other coconut products (coconut milk, coconut meat, etc.) may contain MCT
  • Other dairy products (cheese, yogurt, etc.) may contain small amounts of MCT
• MCT has a low smoking point, so you should not cook with it. Here are some ways to incorporate MCT oil:
  • Drizzle it on salads
  • Add it to smoothies
  • Make bulletproof coffee (or tea, latte, etc.)
  • Add it to bone broth or soup before eating
  • Drizzle it on top of veggies
  • Add it to yogurt, cottage cheese or oatmeal (keto version)
  • Mix it with sauces and dips

Fasting without a gallbladder

Intermittent fasting (IF) is a growing trend, especially with keto dieters. But is it possible to fast without a gallbladder? Yes, but you need to be careful. The key factor is not whether or not you can fast. Because the answer to that is "yes, you absolutely can." Your body can handle not eating for a while, and might actually benefit from taking a break from all that digesting. The tricky part is not the time spent fasting; it's the time spent eating. There are a few factors you need to consider:

1. When you break the fast, can you control yourself enough to eat a small portion? If you break your fast by diving into a pile of food, you might make yourself sick.
2. The most common way to do IF is on a 16:8 schedule: don't eat for 16 hours, then eat for 8 hours. This is doable. I know because I frequently do it myself. However, I do not recommend shortening the eating window to less than 8 hours.
3. What type of fasting are you doing? There are two types:
   1. Nothing except water. This is not impossible, but it's not easy either.
   2. No carbs whatsoever. This is the more common form of IF, and the goal of this type of fast is to prevent any insulin spikes, even in the slightest. This type of fast is much more doable since you can spread out your fat intake throughout the day, even during the fasting hours. So, for example, you could sip on some bulletproof coffee or bulletproof bone broth without breaking your fast.
4. In the end, the most important thing is to listen to your body. If you're hungry: eat. If you're not hungry: don't eat. Once you're in ketosis you may find that you don't get as hungry as often and can do IF naturally. Great! Or you might find that you need to spread out your meals throughout the whole day, and that's fine too. Whatever works for you.

I recommend that you not try to do intermittent fasting until you've been in ketosis for at least a month. For some people it happens naturally. For others, the meals need to be more spread out. Whatever you do, don't force yourself to fast if it shortens your eating window too much. It's not worth getting sick over.

Test your ketone levels

If you are going to do Keto without a gallbladder, your goal should be to stay in ketosis with as few fats as possible. To test whether I'm in ketosis, I use a blood ketone meter because it's more accurate than the urine or breath tests. Typically, on the keto diet your ketone levels should be anywhere from 1.0-3.0. I always hover somewhere between .5 and 1.5, and I'm completely ok with that. It's at the low end of the scale, but the fact that I can do keto without a gallbladder at all is a win in my book. No, I do not lose weight as fast as other keto dieters. But my body has limitations that others don't. It may take me twice as long, but at least the scale is going down and not up!

Occasionally, my ketone levels will reach a 2 or 3 if I am fasting. But it never stays there. If your ketone levels are consistently at this level, I would be hesitant to congratulate you. Only because I am concerned that maintaining that level is overwhelming your liver. If you feel great and have no side effects, then great! Listen to your body and do what feels right. But please be cautious and don't force yourself to maintain that level if you aren't feeling well. Keeping your liver healthy and happy is extremely important, so be kind to it.

Ox-Bile Supplements

Some people swear by this and some people (I'm in this camp) never use them. If you are just starting out with keto and you don’t have a gallbladder, it can be tempting to take a supplement that helps you digest fat. So why am I against it? Because I think it's preferable to let your body learn how to digest fat on its own. I prefer not to rely on supplements.

Now, that being said, if you have tried to start keto and simply cannot get your body to digest fat, then this might be an alternative for you to try. Just make sure that you've given your body a fair shot first, before taking the ox-bile supplements on a regular basis. Alternatively, you might do better on my Low-Carb Mediterranean Diet (included in my meal plan) instead of going full keto. I personally think it’s healthier for you to do my customized diet without supplements, instead of taking ox-bile supplements permanently so that you can force your body into a diet that it’s unable to handle on its own.

I should also mention that there is one condition, called "Biliary Sludge", in which ox-bile salts can be used to help. In this case, your liver is pumping out very thick "sludge" bile and the supplement can help. Note that your liver producing sludge is different from your gallbladder containing sludge. Unless your doctor confirms that you have this condition, my recommendation is to avoid the supplements and allow your body to adjust to the diet naturally.

Other Supplements

• Vitamin D3: if your liver is not working at 100% then you might be low on vitamin D, even if you spend time in the sun. Your doctor can test your vitamin D levels to check.
• As mentioned above, a liver tonic/cleanse supplement can help your liver stay strong.
• Probiotics: regardless of whether you have a gallbladder or not, probiotics are vital to maintaining digestive health.
• Digestive Enzymes: if your gallbladder deteriorated because of long-term digestive issues, then those underlying issues might still be there. Talk to your doctor about this to see if taking digestive enzymes might help.

Step-by-Step Guide and Meal Plan

This is a custom meal plan for anyone who wants to successfully do keto without a gallbladder. Included in this guide are TWO different meal plans to choose from: strict keto and a less-strenuous alternative. Plus, get grocery lists, recipe suggestions, and a tons of information and tips to get you started on the right track.

I wish you all the best of luck on your path to health and wellness! Please feel free to drop a comment below.

To view a PDF version of this webpage, for easy download and printing, click here.

To view a sample of the Meal Plan, click here.